Jingle Bell Run for Arthritis - DC 10K/5K
Saturday, December 8, 2001  9:00 AM

Make check payable to: Arthritis Foundation
Mail to: Jingle Bell Run 10K/5K-DC, 13710 Ashby Road, Rockville, MD 20853-2903
Fax to: (301) 871-0006 before December 5     Do Not Mail After December 3

Today's Date: , 2001         Event: 10K   5K   
Entry Fee: $25      $30 if postmarked after December 1 and on raceday
Kids under 12 - $10
Additional contribution to Arthritis Foundation $ ___________    Wheelchair     I want to volunteer
I am a ChampionChip owner and am deducting $2.  My Chip number is  
I want to buy my own ChampionChip.  I am enclosing $35 payable to Capital Running Co.
I want to run on a team. My Team/Company name is: _______________________

Last Name:
Address:
City: State: Zip: -
Age on race day: Sex: M F         E-Mail:
Date of Birth: / / Shirt Size:   S M L XL      
Day Phone: - - Night Phone: - -

Credit Card: MC VisaAmex - - - Exp:
Cardholder's Signature (Mandatory) __________________________________________
Would you participate in the Jingle Bell Run next year if the event took place on a Saturday instead of a Sunday? Yes   No 

Waiver/Release Must be Signed Before Mailing:

I know that running is a potentially hazardous activity and I should not enter unless I am medically able and properly trained. I assume all risks associated with running in this event including, but not limited to, falls, contact with other participants, the effects of weather and the conditions of the road, all such risks being known and appreciated by me. Having read this waiver and knowing the facts and inconsideration of your accepting my entry, I, for myself, and anyone else acting on my benefit waive and release and indemnify the Jingle Bell Run for Arthritis, Arthritis Foundation,  Capital Running Company, plus all sponsors, their representatives and assignors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Finish line services by Capital Running Company.

_________________________________________________________ __________
Signature (parent or guardian if under 18)                                                          Date